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General NPI Number Information
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NPI Number | 1194662965
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Entity Type | Organization
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Legal Business Name | WHOLISTIC ALLIANCE
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 7000 S RACINE AVE
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City | CHICAGO
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State | IL
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Zip | 60636-3509
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Country | US
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Telephone | 872-302-5290
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Fax | 872-302-5291
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Provider Business Mailing Address
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Address Line | 1442 W 74TH ST
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City | CHICAGO
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State | IL
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Zip | 60636
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Country | US
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Telephone | 872-302-5290
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Fax | 872-302-5291
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHELIA MARTIN
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Credential | APRN
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Telephone | 773-699-8573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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